Provider Manual
Provider Manual Updated - July 2010
The Provider Manual has recently undergone extensive revisions and includes important updates on doing business with NHP. Let us know what you think! We welcome your feedback for enhancing this important provider reference tool. Contact us at prweb@nhp.org with your suggestions and ideas.
Provider Manual
- Welcome Letter
- NHP Member Information
updated July 2010 - Provider Management
updated July 2010 - Quality Management Programs
updated July 2010 - Clinical Programs
updated July 2010 - Utilization Management
updated July 2010
- Billing Guidelines
updated July 2010
- Pharmacy
updated July 2010 - Appeals and Grievances
updated July 2010 - Dental and Vision
updated July 2010 - Contact Information
updated July 2010 - Glossary of Terms
The NHP Provider Manual provides convenient web links to many other resources on the NHP website. In addition, the Manual provides links to websites outside www.nhp.org. Please note that NHP does not control the content of links outside of the NHP website, and therefore the information on these external links may not have been reviewed or approved by Neighborhood Health Plan.
The Provider Manual will be updated as needed, and at a minimum on an annual basis. A Provider Manual Update Notice will be posted informing providers of any changes. It is the provider's responsibility to review the on-line Provider Manual for updates to our billing guidelines and other policies and procedures. Neighborhood Health Plan, at its discretion and/or in accordance to contract obligations, will provide advance written notice of changes to our policies and procedures.
Behavioral Health Provider Manual - Beacon Health Strategies
NHP has contracted with Beacon Health Strategies to manage the delivery of behavioral health services for all NHP Members. This manual is an administrative guide outlining Beacon's policies and procedures governing service provision, claims submission, and quality management and improvement requirements.
NHP Commonwealth Care - Dental Coverage Manual
To access the Doral Dental Coverage Manual, please register at the DoralUSA.com website.